CHVI and Cardinal Health Specialty Solutions produce webinar focused on pathways to improving patient Outcomes
ESTERO, FLA. – August 31, 2012 –When cancer patients are given more of a voice in their own care, many choose less intervention rather than more, experts say. Further, when patients and their clinicians are aligned in evidence-based treatments and care coordination, quality of life is enhanced while of quality of health care is improved.
These findings, part of a presentation at the Center for Health Value Innovation’s recent webinar on “Specialty Solutions for Oncology,” are part of many pieces of evidence that plan designers can use to contain the costs of cancer care, one of the fastest-growing segments of health spending.
“Cancer is a scary disease and people who have it deserve effective, evidence-based care,” said Cyndy Nayer, president of the Center. “Designers of health plans can take advantage of the best modern science has to offer by considering all of those affected by cancer, including the health system, the patient and family, and the care providers, surrounding them with the evidence, quality of life, and best outcomes for their disease, while at the same time keeping their financial health under control.”
“Many patients prefer a less aggressive approach, especially at end of life,” Bruce Feinberg, D.O., chief medical officer, Oncology, for Cardinal Health Specialty Solutions. “By including the patient in decision-making as a stakeholder and paying attention to evidence-based treatment pathways, care providers and health plans can achieve the best possible results for the patient without posing unfair cost burdens to families.”
Cardinal Health Specialty Solutions’ approach includes such measures as matching treatment to disease through evidence-based and peer-reviewed studies, then working with providers to develop the treatment pathways they will follow. Pathways offer one of the rare opportunities in which all health care stakeholders can be similarly benefitted. Providers collaborate with payers to reduce inefficiencies and waste while achieving consensus about uniform standards of care. Patients then benefit from the lower costs and improved standards,” said Feinberg.
Jack Mahoney, M.D., M.P.H., chief medical officer, Center for Health Value Innovation, presented the full-market implications of specialty solutions for cancer care. Focusing on employers and health plans as plan sponsors, he cited the evidence of rising use of balancing cost control measures while assuring access to high quality care by plan sponsors and carve-out specialty pharmacy managers as published by PBMI (Pharmacy Benefit Management Institute), an early ally of the Center.
“We are cataloguing cost-control mechanisms in cancer care and other specialty solutions that are quite similar to those we saw for many years in chronic care solutions: prior authorizations, tiering, cost-sharing, and more,” said Dr. Mahoney. “And, as we might expect, with more administrative burden or cost-shifting to the patient, we are also seeing potential barriers to treatment adherence. Therefore, our Center is identifying innovations in specialty solutions that keep administrative burden and costs simpler for these individuals who can significantly benefit from the new treatments.”
One of the earliest supporters of the Center’s focus on outcomes-based contracting has been Laurie Amirpoor, Pharm.D., vice president of clinical pharmacy strategies for WellPoint Inc. and a member of the Center’s Board of Directors. Dr. Amirpoor encouraged plan designers to design future plans that avoid high out-of-pocket costs for cancer drugs, citing studies that find patients are more likely to abandon such treatments. Instead, she recommended such cost management mechanisms as quantity management, adherence monitoring and following established treatment pathways.
John Poniatowski, Vice President of Clinical Pharmacy for Specialty Pharmacy at Cigna, highlighted the approach used by his company. “Our holistic care model focuses on the patient, not just the drug,” he said, “we make sure care is affordable, outcomes are improved through adherence and superior service is provided. As a health care company, we believe an integrated approach, including all of the patient information on one health technology platform so all caregivers can review treatment plans and more, is fundamental to the better outcomes for everyone.”
“We chose our speakers to reinforce the message of focusing on the outcomes and appropriate, evidence-based care paths to get there,” said Nayer. “Each of these companies has received kudos from us for their early adoption of outcomes-based contracts. We have been outspoken not only on value but on the outcomes-based contracts that align the patient, payer, plan sponsor and providers in a treatment path in which all can achieve well-defined goals. Each of these organizations embraces the science of health care with the humanity of health outcomes. Each has shared their philosophies and analyses with us as members of our Center.”
Nayer commended the group on their efforts to present various perspectives to the large audience of health plans and employers who gathered for the webinar. “Together, we are forging new paths in care outcomes that include better health and financial outcomes. We have become the innovation hub for care coordination and plan design that we hoped to achieve. Based on the hundreds of health care decision-makers who registered for this first thought-leader event, we’re confident that we’ll be seeing greater innovation in plan design for oncology and other high-cost and debilitating conditions. We will be scheduling more of these summits and webinars for our members and publishing the results so that communities throughout the United States will derive the benefit of thought leaders such as ours.”
About the Center for Health Value Innovation (CHVI)CHVI (501c3) is focused on the relentless pursuit of innovation in health and benefit designs that improve engagement, accelerate accountability and create a predictable health cost trend. CHVI members represent over 60 million lives from all market segments in the health value supply chain, sharing the evidence of improved health and economic outcomes through value-based designs, including the Outcomes-Based Contracting™ platform for accelerating meaningful change. The Center for Health Value Innovation’s goal is to improve the health of people, organizations and communities throughout the U.S. www.vbhealth.org# # #